The definitive contraceptive method raises many questions: does it really work? Is the operation complicated? Can you go back? see the answers
Tubal ligation is a definitive method of contraception – it’s actually a sterilization. From the moment the procedure is performed, the woman can no longer become pregnant. For this to happen, the doctor cuts the tubes or fallopian tubes and “ties” the ends. This way, the passage of eggs and sperm is blocked, preventing fertilization. According to obstetric surgeon Renato Sá, of the Perinatal Maternity Hospital (RJ), it is generally a quick and low-risk operation.
Binding or lacquering?
Anything. “People tend to say, ‘I didn’t plug the tubes, I did tubal ligation.’ Or the other way around. Many people think one is reversible and the other is not. In fact, ligature and ligature are synonyms. The procedure is the same,” explains the specialist.
Types of tubal ligation
Although the procedure is the same, according to Renato, it is possible to divide it according to when it is performed: immediately after the normal birth, immediately after the cesarean section or in other moments not preceded by births or abortions.
Before the new draft law amending the tubal ligation legislation, which was passed in September last year and went into effect in March, it was not allowed to perform the postpartum or post-cesarean procedure. Now, the woman can request the benefit, as long as 60 days before the birth.
– Tubal ligation after cesarean section
“After the cesarean section, the tubes are accessible, therefore the doctor performs the direct ligation“, explains Renato. The woman is already anesthetized and, according to the obstetrician, this adds about 5 minutes to the duration of the tubal surgery, or even less. It doesn’t affect anything,” he says.
– Tubal ligation after normal delivery
Tubal ligation after normal childbirth is performed by a small incision in the periumbilical region (near the navel). “Most of the time, short-term spinal anesthesia is applied,” says the surgeon. “The influence on recovery is also very small. The woman has more postpartum symptoms than ligation-related symptoms,” he adds.
– Ligation by videolaparoscopy
When tubal ligation is not done immediately after delivery or abortion, videolaparoscopy, a type of minimally invasive surgery, is usually chosen. made with cameras, with small incisions. “Usually it’s done with sedation. It’s quick and takes about 20 minutes or less. Most of the time the woman goes into the hospital in the morning and, at the end of the day, she’s discharged,” says the specialist.
Pregnancy after tubal ligation
The tubal ligation procedure is one of the most effective methods of contraception, with a failure rate of just 0.5%. Renato explains that, however, the body has a tendency to restore the way it worked before the “injury”, that is, how it “understands” the obstruction of the tubes. “Even if a small piece was taken and tied, still [ em casos raríssimos]he manages to make a small hole and get the egg through,” he says. But it’s worth reinforcing: the chance of this happening is minimal..
Who can do the lacquering?
Tubal ligation can be performed by women who no longer want to have children and who prefer to opt for a definitive method rather than short-term options – condoms and birth control pills, for example – or medium-term options, such as hormonal implants and intrauterine devices (IUD). ).
With the new law, Any woman aged 21 and older can have a tubal ligation, whether or not she has children. If you have two or more children, you can opt for sterilization from the age of 18. In any case, a minimum interval of 60 days is required between the manifestation of the will to undergo the procedure and its execution. “During this period, the woman must undergo multidisciplinary counseling, which includes discussions with various health professionals, psychologists, social workers and doctors. This team must inform her about the pros and cons of each contraceptive method, so that she can make a safe choice “, underlines Renato.
Before the change in the legislation, the consent of the spouse was also required for the execution of the binding, because it was understood that the decision on fertility had to be taken jointly by the couple. Now, prior approval from the husband or wife is no longer required for both tubal ligation and vasectomy.
Pain, sex and menstruation after tubal ligation
According to the doctor, the three big myths related to tubal ligation are pain, increased bleeding, and decreased libido. “None of the three are scientifically proven,” she says.
Explain that any scar, such as a cut on your finger, will make the region more sensitive for a time. However, the procedure is so minor that there is little chance that the person will experience pain from the surgery itself. “The expectation is that the woman doesn’t have any symptoms,” she adds.
It also has nothing to do with menstruation. “The tube is a tube, without any hormonal function. What you do is put a barrier in that tube,” Renato says. In cases where tubal ligation is performed during delivery or cesarean section, menstruation returns after the normal spacing that occurs after pregnancy. When the procedure is done at intervals other than pregnancies, it does not interfere with the menstrual cycle.
To resume sexual life, when there is childbirth, the ideal is for the woman to wait the 45 days recommended during the puerperium. “In other cases, as soon as she feels better after the postoperative process, sexual activity is released,” she advises.
How to know if lacquering worked?
The chance of a tubal ligation failure is very small. According to the specialist, there is an examination that shows whether or not the passage through the tube is blocked, but, due to the risks and complexity, it is not recommended. “A hysterosalpingography it is an iodine contrast test, but the test is painful and there is a risk of anaphylactic reactions, due to the iodine. Since tubal ligation is done with a direct view of the tube, there is no need for double checking,” he says.
Is tubal ligation reversible?
Yes, even if it is a definitive contraceptive method. “However, it’s not that accessible, because it depends on a specific technology to recalibrate the pipe. the efficacy of tubal recanalization is not very high”, comments Renato, adding that the success rate of the reversal is usually 15-20%.
From the previously mentioned hysterosalpingography examination it is possible to know if the tube is permeable. However, even if it is, this does not necessarily indicate that it is functional and that there may be pregnancy after tubal ligation.
Can tubal ligation be done through SUS or health insurance?
Tubal ligation can be done through the public network. For this reason, the woman should look for the Basic Health Unit closest to her home and express the desire to have her tubes connected. From then on, she should be forwarded to consultations with the multidisciplinary team pending the so-called 60-day “thinking time”. With endorsement in hand, she proceeds to the appointment. With determination of the National Health Agency (ANS), the insurance also covers contraceptive and family planning proceduresincluding tubal ligation.
Stay tuned!
An important reminder: From the moment you have a tubal ligation, you are almost completely protected from an unwanted pregnancy. But it is important to keep this in mind you still need to protect yourself – with condoms, for example – from sexually transmitted infections.
Source: Terra
Ben Stock is a lifestyle journalist and author at Gossipify. He writes about topics such as health, wellness, travel, food and home decor. He provides practical advice and inspiration to improve well-being, keeps readers up to date with latest lifestyle news and trends, known for his engaging writing style, in-depth analysis and unique perspectives.
